Durable response of a radiation-induced, high-grade cerebellar glioma to temozolomide

J Neurooncol. 2007 Sep;84(2):179-83. doi: 10.1007/s11060-007-9354-y. Epub 2007 Mar 1.

Abstract

Background: Radiation-induced high-grade gliomas are a rare but serious late complication of radiotherapy. We report a patient with radiation-induced cerebellar high-grade glioma who had a durable response to temozolomide.

Patients and methods: Case report of a 77-year-old woman with a radiation-induced, high-grade cerebellar glioma that responded durably to temozolomide.

Results: Our patient developed a cerebellar high-grade glioma 9 years after treatment for a stage IV (T4N0M0) supraglottic laryngeal squamous cell carcinoma with cisplatinum and fluorouracil chemotherapy, and subsequently focal head and neck radiotherapy. Patient was treated with radiation and concurrent temozolomide (only partially due to toxicity) and was stable for 1 year without further adjuvant treatment. Subsequently the tumor recurred and the patient had a dramatic and durable response to standard 5 day dosing of adjuvant temozolomide.

Conclusion: High-grade gliomas are a late complication of radiation to the central nervous system and may respond to chemotherapy.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antineoplastic Agents, Alkylating / therapeutic use*
  • Carcinoma, Squamous Cell / radiotherapy
  • Cerebellar Neoplasms / drug therapy*
  • Cerebellar Neoplasms / etiology
  • Cerebellar Neoplasms / pathology
  • Dacarbazine / analogs & derivatives*
  • Dacarbazine / therapeutic use
  • Diagnosis, Differential
  • Female
  • Glioma / drug therapy*
  • Glioma / etiology
  • Glioma / pathology
  • Humans
  • Laryngeal Neoplasms / radiotherapy
  • Magnetic Resonance Imaging
  • Neoplasm Recurrence, Local / pathology
  • Neoplasms, Radiation-Induced / drug therapy*
  • Neoplasms, Radiation-Induced / pathology
  • Neoplasms, Second Primary / drug therapy*
  • Neoplasms, Second Primary / etiology
  • Neoplasms, Second Primary / pathology
  • Positron-Emission Tomography
  • Radiotherapy / adverse effects
  • Temozolomide

Substances

  • Antineoplastic Agents, Alkylating
  • Dacarbazine
  • Temozolomide